Editing Schizophrenia (section)

===Psychosocial interventions===
{{Further|Management of schizophrenia#Psychosocial}}
A number of psychosocial interventions that include several types of [[psychotherapy]] may be useful in the treatment of schizophrenia such as: [[family therapy]],<ref name=Pharoah2010>{{cite journal | vauthors = Pharoah F, Mari J, Rathbone J, Wong W | title = Family intervention for schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 12 | issue = 12 | pages = CD000088 | date = December 2010 | pmid = 21154340 | pmc = 4204509 | doi = 10.1002/14651858.CD000088.pub2 | veditors = Pharoah F }}</ref> [[group therapy]], cognitive remediation therapy (CRT),<ref>{{cite journal | vauthors = Bellani M, Ricciardi C, Rossetti MG, Zovetti N, Perlini C, Brambilla P | title = Cognitive remediation in schizophrenia: the earlier the better? | journal = Epidemiology and Psychiatric Sciences | volume = 29 | issue =  | pages = e57 | date = September 2019 | pmid = 31556864 | pmc = 8061237 | doi = 10.1017/S2045796019000532 }}</ref> cognitive behavioral therapy (CBT), and [[metacognitive training]].<ref>{{cite journal | vauthors = Philipp R, Kriston L, Lanio J, Kühne F, Härter M, Moritz S, Meister R | title = Effectiveness of metacognitive interventions for mental disorders in adults-A systematic review and meta-analysis (METACOG) | journal = Clinical Psychology & Psychotherapy | volume = 26 | issue = 2 | pages = 227–240 | date = March 2019 | pmid = 30456821 | doi = 10.1002/cpp.2345 | s2cid = 53872643 }}</ref><ref>{{cite journal | vauthors = Rouy M, Saliou P, Nalborczyk L, Pereira M, Roux P, Faivre N | title = Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders | journal = Neuroscience and Biobehavioral Reviews | volume = 126 | issue =  | pages = 329–337 | date = July 2021 | pmid = 33757817 | doi = 10.1016/j.neubiorev.2021.03.017 | s2cid = 232288918 | url = https://hal.archives-ouvertes.fr/hal-03178486/file/2020.12.03.20243113v1.full.pdf }}</ref> Skills training, help with substance use, and weight management – often needed as a side effect of an antipsychotic – are also offered.<ref>{{cite journal | vauthors = Dixon LB, Dickerson F, Bellack AS, Bennett M, Dickinson D, Goldberg RW, Lehman A, Tenhula WN, Calmes C, Pasillas RM, Peer J, Kreyenbuhl J | title = The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements | journal = Schizophrenia Bulletin | volume = 36 | issue = 1 | pages = 48–70 | date = January 2010 | pmid = 19955389 | pmc = 2800143 | doi = 10.1093/schbul/sbp115 }}</ref> In the US, interventions for first episode psychosis have been brought together in an overall approach known as [[coordinated speciality care]] (CSC) and also includes support for education.<ref name=RAISE/> In the UK ''care across all phases'' is a similar approach that covers many of the treatment guidelines recommended.<ref name=NICE2014/> The aim is to reduce the number of relapses and stays in the hospital.<ref name=Pharoah2010/>

Other support services for education, employment, and housing are usually offered. For people with severe schizophrenia, who are discharged from a stay in the hospital, these services are often brought together in an integrated approach to offer support in the community away from the hospital setting. In addition to medicine management, housing, and finances, assistance is given for more routine matters such as help with shopping and using public transport. This approach is known as [[assertive community treatment]] (ACT) and has been shown to achieve positive results in symptoms, social functioning and quality of life.<ref>{{cite journal | vauthors = Bond GR, Drake RE | title = The critical ingredients of assertive community treatment. | journal = World Psychiatry | date = June 2015 | volume = 14 | issue = 2 | pages = 240–242 | doi = 10.1002/wps.20234 | pmid = 26043344| pmc = 4471983 }}</ref><ref>{{cite journal | vauthors = Smeerdijk M | title = [Using resource groups in assertive community treatment; literature review and recommendation]. | journal = Tijdschrift voor Psychiatrie | date = 2017 | volume = 59 | issue = 8 | pages = 466–473 | pmid = 28880347}}</ref> Another more intense approach is known as ''intensive care management'' (ICM). ICM is a stage further than ACT and emphasises support of high intensity in smaller caseloads, (less than twenty). This approach is to provide long-term care in the community. Studies show that ICM improves many of the relevant outcomes including social functioning.<ref>{{cite journal | vauthors = Dieterich M | title = Intensive case management for severe mental illness | journal=The Cochrane Database of Systematic Reviews | date = 6 January 2017 | volume = 1 | issue = 1 | page = CD007906 | doi = 10.1002/14651858.CD007906.pub3 | pmid = 28067944| pmc = 6472672 }}</ref>

Some studies have shown little evidence for the effectiveness of CBT in either reducing symptoms or preventing relapse.<ref>{{cite journal | vauthors = Jauhar S, McKenna PJ, Radua J, Fung E, Salvador R, Laws KR | title = Cognitive-behavioural therapy for the symptoms of schizophrenia: systematic review and meta-analysis with examination of potential bias | journal = The British Journal of Psychiatry | volume = 204 | issue = 1 | pages = 20–29 | date = January 2014 | pmid = 24385461 | doi = 10.1192/bjp.bp.112.116285 | type = Review | doi-access = free }}</ref><ref name=Jones2018>{{cite journal | vauthors = Jones C, Hacker D, Meaden A, Cormac I, Irving CB, Xia J, Zhao S, Shi C, Chen J | title = Cognitive behavioural therapy plus standard care versus standard care plus other psychosocial treatments for people with schizophrenia | journal = The Cochrane Database of Systematic Reviews | volume = 11 | issue = 11 | pages = CD008712 | date = November 2018 | pmid = 30480760 | pmc = 6516879 | doi = 10.1002/14651858.CD008712.pub3 }}</ref> However, other studies have found that CBT does improve overall psychotic symptoms (when in use with medication) and it has been recommended in Canada, but has been seen to have no effect on social function, relapse, or quality of life.<ref>{{cite journal | title = Cognitive Behavioural Therapy for Psychosis: A Health Technology Assessment| journal = Ontario Health Technology Assessment Series | date = 2018 |volume = 18 | issue = 5 |pages = 1–141 | pmid = 30443277 | pmc = 6235075  | author = Health Quality Ontario }}</ref> In the UK it is recommended as an add-on therapy in the treatment of schizophrenia.<ref name=nhsTreatment/><ref name=Jones2018/> [[Expressive therapies|Arts therapies]] are seen to improve negative symptoms in some people, and are recommended by NICE in the UK.<ref name=nhsTreatment>{{cite web | title = Schizophrenia – Treatment | url = https://www.nhs.uk/conditions/schizophrenia/treatment/ | publisher= UK [[National Health Service]] | access-date = 8 January 2020 | date = 23 October 2017}}</ref> This approach is criticised as having not been well-researched,<ref>{{cite journal | vauthors = Ruddy R, Milnes D | title = Art therapy for schizophrenia or schizophrenia-like illnesses | journal = The Cochrane Database of Systematic Reviews | issue = 4 | page = CD003728 | date = October 2005 | pmid = 16235338 | doi = 10.1002/14651858.CD003728.pub2 | url = http://www.cochrane.org/reviews/en/ab003728.html | archive-url = https://web.archive.org/web/20111027132811/http://www2.cochrane.org/reviews/en/ab003728.html | df = dmy-all | url-status=live | archive-date = 27 October 2011 }}</ref><ref>{{cite journal | vauthors = Ruddy RA, Dent-Brown K | title = Drama therapy for schizophrenia or schizophrenia-like illnesses | journal = The Cochrane Database of Systematic Reviews | issue = 1 | page = CD005378 | date = January 2007 | pmid = 17253555 | doi = 10.1002/14651858.CD005378.pub2 | url = http://www.cochrane.org/reviews/en/ab005378.html | archive-url = https://web.archive.org/web/20110825024045/http://www2.cochrane.org/reviews/en/ab005378.html | df = dmy-all | url-status=live | archive-date = 25 August 2011 }}</ref> and arts therapies are not recommended in Australian guidelines for example.<ref>{{cite journal |vauthors=Galletly C, Castle D, Dark F, et al |title=Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders |journal=Aust N Z J Psychiatry |volume=50 |issue=5 |pages=410–472 |date=May 2016 |pmid=27106681 |doi=10.1177/0004867416641195 |s2cid=6536743 |url=|doi-access=free }}</ref> [[Peer support#In mental health|Peer support]], in which people with [[experiential knowledge|personal experience]] of schizophrenia, provide help to each other, is of unclear benefit.<ref>{{cite journal |vauthors= Chien WT, Clifton AV, Zhao S, Lui S |title=Peer support for people with schizophrenia or other serious mental illness. |journal=The Cochrane Database of Systematic Reviews |date=4 April 2019 |volume=4 |issue=6 |page=CD010880 |doi=10.1002/14651858.CD010880.pub2 |pmid=30946482|pmc=6448529 }}</ref>